Dry Eye Characterisation and Symptoms

Dry Eye Characterisation

Severe cases of DES in people living with diabetes leads to visual impairment (disturbances to the corneal layer can alter how light enters the eye), corneal scarring and ulcers (without sufficient protective tear film which contains anti-bacterial compounds, wounds on the cornea will be slow to heal and susceptible to infection), leading to secondary bacterial infections that can spread. The synergistic effect of corneal infection and diabetes accelerates corneal lesions, which irreversibly change the ocular surface and induce visual impairment. Tear film dysfunction not only leads to the occurrence of dry eye but simultaneously aggravates the ocular surface, which induces a corneal epithelial defect and keratopathy, more information can be found in the Diabetes-related Keratopathy section.

Dry Eye Symptoms

People living with diabetes with dry eye may experience the same symptoms as people living with dry eye without diabetes. The symptoms consist of:

  • A gritty sensation
  • Soreness
  • Decreased visual acuity
  • Photophobia (discomfort or pain to the eyes due to light exposure)
  • Itching
  • Decreased goblet cell density (a loss of cells that produce mucins which act as a defense against ocular surface damage)
  • Corneal sensitivity
  • Excessive tearing
  • Pain


More severe cases may be complicated by corneal lesions, conjunctivitis, keratopathy, and inflammation. Lack of symptoms may result from a reduction in corneal sensitivity caused by diabetes-related peripheral corneal neuropathy 24.  Even a minimal decrease in corneal sensitivity is sufficient to cause changes in tear secretion.

Dry eye symptoms are typically severe for patients living with diabetes finding glycemic management challenging.


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